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Sunday, September 22, 2013

Indigent Patients and the Difficulties accessing healthcare in FCT

Despite efforts initiated by the federal government to ease access to qualitative healthcare delivery in Nigeria, absence of realistic policy to assist indigent patients has continued to deny many Nigerians access to medical services. Uche Uduma visited some hospitals in Abuja and writes on the pains less privileged patients go through to access healthcare

Lying helplessly on her bed 19 years old Deborah John tossed and turned in pains, as if each turn would put her pains to a stop, however each toss sends a fresh wave of pains reverberating through her body. It was Deborah’s third day in one the female wards in Kuje General Hospital, yet she has not been able to access medical care. Deborah was diagnosed with Anemia and all she needed is 10,000 naira to get a blood transfusion, however her husband who couldn’t afford money to buy blood from the blood bank abandoned her at the hospital.

As they say, it doesn’t just rain, it also pours. For Deborah being sick is bad enough and being abandoned by her husband because of inability to pay her medical bills is too much to bear. The young woman who spoke with LEADERSHIP Sunday revealed that she has been trying to raise money for her blood transfusion however she is yet to get help.

According to her “I have been in the hospital for a couple of days. I have pains all over my body and I feel very weak. The nurses said that I have Anemia and I need some blood transfusion. My husband doesn’t have any money, he went to find money to buy blood and we have not seen him since then. My mother and my father are here but they don’t have money to pay for the blood.”

Also in the female ward at Kuje Hospital is another indigent patient (names withheld) who was operated upon and discharged, but has been held back at the hospital for inability to pay her medical bills. These two patients in Kuje General Hospital make a vivid picture of indigent patients unable to foot their medical bills in different hospitals across the FCT. One can barely drive through the beautiful express ways in Abuja, without seeing indigent patients with life-threatening illnesses begging for assistance along road sides, motor parks, streets and even offices.

Another indigent patient who spoke with LEADERSHIP Sunday is Usman Kachako, a 33-year-old plumber who was involved in an accident and needed a surgery to correct the injury on his leg. According to him “I was involved in an accident in 2012, I did the first operation on the leg, I was told to come back to operate on the leg the second time but I can’t afford to pay the huge amount the doctor is demanding. I was told to pay N346,000 but I don’t have the money that’s why I am begging for assistance.”

While many people are skeptical about giving assistance to these aged and sick patients seen along the road sides, the question remains what policy is put in place for indigent patients in different hospitals spread across Abuja?

The Chief Medical Director of Gariki Hospital, Dr Elijah Miner in an interview with LEADERSHIP Sunday, stated that as part of efforts to reach out to every category of patients, hospital fees and ward fees have been slashed in Gariki hospital. According to him “we have experimented categories of fees and for those who are VIPs they are ready to pay anything but we said let’s crash down our consultation fee and keep our ward fee fairly low.”

“Then again, Premier Hospital deem it necessary, as a follow up to this policy to open what we call a Pro-poor fund for indigent of FCT, in which case, if the patient doesn’t have money, such fund can therefore be drawn to treat such patients. We have cases of pregnant women who did not even have money and they have complications at the point of delivery and we had to save the mother and the baby first, he said.

Indigent patients in National Hospital Abuja seem to have fared better than their mates in other hospitals, as the hospital has Social Medical Welfare Department which caters for the needs of the indigent patients. The Head Management Information Services, National Hospital, Dr Tayo Haastrup who spoke with LEADERSHIP Sunday stated that the hospital’s welfare in collaboration with good spirited Nigerians assist confirmed indigent patients in the hospital.

According to him, “Indigent patients are those patients that cannot afford to pay for medical services in the hospital. Probably they are not working, but they cannot afford to pay any charge in the hospital. We also have accident victims that were brought to the hospital, the people that brought them abandoned at the hospital. For indigent patients, what we do is that we either waive the charges for them or we totally render the medical service free. But the good news is that National Hospital has Social Medical Welfare Department which is designated to be in charge of these indigent patients. They go round and find out these indigent patients and any case of needy patient in the National Hospital is being referred to social medical welfare department, where they investigate to authenticate whether a particular patient is indigent or not.”

“If you look at our records, yearly we have waivers, and it runs into millions of naira. Hospital has to run, we buy consumables, we service the equipment and it is money that we are using to do all these things. So if we are now saying that we are having a huge amount of indigent patients and huge amount of waivers it will be running into millions of naira in a year, so how do we render our services? So that’s why we make sure that we do very serious verification to be sure that these patients that claim that they are indigent patients are indeed indigent patients. We also have cases of abandoned babies, some parents abandon their sick babies at the hospital. And when we have done whatever we could do and all the services rendered for the baby, the social medical service will contact the institution medical welfare so that we can take them to any of the orphanages in town.”

Dr Haastrup however, stated that the policy for indigents in the hospital is to wave their bills completely or to reduce the bill.

“We do some waiver or we don’t collect anything at all. We also have organisations that take care of the needs of indigent patients, some religious and corporate organisations. Sometimes they donate to the indigent patients or clear their bills. We also have account called friends of the hospital account, that account is dedicated to indigent patients. If you want to give money to indigent patient and you don’t want to identify any of them, you can pay into the account.”

While the big hospitals in Abuja, have a sort of policy for their indigent patients, the Primary Healthcare centres as well as General hospitals still do not have policy for their indigent patients.

A source in general Hospital Kuje who doesn’t want her name on print told LEADERSHIP Sunday that policies concerning hospitals are made by the Hospitals Management Board, however some good spirited individuals can come in and give assistance to the indigent patients.